摘要
目的探讨睾丸肿瘤的CT表现,提高术前诊断水平。方法回顾性分析经手术病理证实的原发睾丸肿瘤22例的CT资料,其中精原细胞瘤12例,恶性混合性生殖细胞瘤3例,内胚窦瘤2例,胚胎性癌、良性畸胎瘤、莱狄细胞瘤、胚胎性横纹肌肉瘤、非霍奇金淋巴瘤各1例。结果CT检出肿瘤100%,22例肿瘤密度均高于对侧睾丸,平扫时可略低于肌肉,增强扫描等于或稍高于肌肉。睾丸肿大21例,肿瘤边缘清楚16例,边缘不清6例,见于精原细胞瘤5例(5/12,占42%),非精原细胞瘤1例(1/6,占17%)。密度均匀10例,密度不均12例,见于精原细胞瘤5例(5/12,占42%),见于非精原细胞瘤6例(6/6,占100%),见于胚胎性横纹肌肉瘤1例(1/1,占100%)。伴有鞘膜积液6例,伴有钙化3例,其中良性畸胎瘤为粗大钙化。结论CT能检出睾丸肿瘤,但不能准确区分精原细胞瘤与非精原细胞瘤,如肿物密度相对均匀,则精原细胞瘤可能大。临床病史及正确调节窗宽能为发现并正确诊断睾丸肿瘤提供帮助。
Objective To discuss the CT manifestations of testicular tumors. Methods CT images of 22 patients with pathologically proved primary testicular tumor were analyzed retrospectively, including 12 seminomas, 3 malignant mixed germ cell tumors, 2 yolk sac tumors, 1 benign teratoma, 1 leydig cell tumor, 1 Rhabdomyosarcomas, and 1 lymphoma. Results CT could correctly demonstrate all of the 22 tumors （ 100% ）. Density of tumors was higher than normal testis, and lower than muscles on unenhanced CT scan; while equal to or slightly higher than muscles on enhanced CT scan. Testis enlargement was seen in 21 cases. Tumors with well - defined margin were seen in 16 cases, ill - defined margin in 6 cases, 5 in seminoma （42%）, 1 in non- seminoma （ 17% ）, tumors with homogenous appearance were seen ill 12 cases, heterogenous appearance in 12 cases, 5 in seminoma （42%）, 6 in nonseminoma （100%）, 1 in Rhabdomyosarcomas （100%） .6 cases with hydroceles, 3 cases with calcify. Conclusion CT can detect testicular tumors, but cannot distinguish seminoma from nonseminoma correctly, if the tmnor get a more homogenous appearance, it is more likely to be a semonoma. Clinical history and right window width can help to make a correct diagnosis.
出处
《癌症进展》
2006年第5期456-461,共6页
Oncology Progress
关键词
睾丸肿瘤
CT
诊断
testicular tumors CT diagnosis
